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Saint-André-lez-Lille, France

Simon N.,Institute Of Pharmacie | Simon N.,Lille University of Science and Technology | Simon N.,Laboratoire Of Biopharmacie | Romano O.,Service dOncologie et de Medecine Interne | And 12 more authors.
Cancer Chemotherapy and Pharmacology

Purpose: Ensuring the correct administration of antineoplastic drugs is a constantly challenging task. Nowadays, several specific infusion devices have been marketed to decrease occupational exposure to these drugs through a post-administration rinsing step. As their impact on drug pharmacokinetics has never been evaluated, the objective of this study was to assess how the infusion process may alter the pharmacokinetics of antineoplastic drugs. Methods: We developed a prospective randomized multicenter pharmacokinetic study (ONCOPERF01) to compare the influence of three infusion techniques (gravity-fed infusion - GFI, infusion pump - IP, and gravity-fed infusion with post-administration rinsing - PAR) to assess the impact of both flow rate and post-administration rinsing on gemcitabine pharmacokinetics during three consecutive administrations. Gemcitabine pharmacokinetics was determined with a two-compartment model after plasma dosing with an HPLC-UV method. Statistical comparisons of the three groups were made using repeated-measure analysis of variance (PROC MIXED). Results: Patients received gemcitabine by gravity-fed infusion (GFI, n = 9; IP, n = 9; PAR, n = 7). Significant differences were noted between infusion duration (GFI = 30.0 ± 2.6 min, IP = 29.1 ± 1.2 min, PAR = 33.7 ± 3.5 min; p = 0.003) and AUCt (GFI = 23.5 ± 8.2 μM h, IP = 25.4 ± 9.1 μM h, PAR = 28.5 ± 6.3 μM h; p = 0.0009), which was significantly higher in the infusion group with post-administration rinsing than in the other groups. Conclusions: The ONCOPERF01 study indicates that post-administration rinsing leads to a significant increase in patient exposure to gemcitabine, whereas controlling flow rate has no significance. Further surveys are required to assess the impact of such infusion techniques on other antineoplastic drugs. © 2015 Springer-Verlag Berlin Heidelberg. Source

Vorilhon P.,University dAuvergne | Deat J.,University dAuvergne | Gerard A.,University dAuvergne | Laine E.,Laboratoire Of Biopharmacie | And 4 more authors.
Revue des Maladies Respiratoires

Introduction.: Screening for COPD is currently considered to be insufficient. Electronic minispirometers allow screening for COPD in general practice. Objectives: To assess the prevalence of COPD in a population of at-risk patients in general practice (GP) and to identify the high-risk factors for the disease. Methods: A cross-sectional study was performed in a GP setting. Patients aged between 40and 75 years with a history of smoking, occupational exposure to toxic substances or chronic respiratory symptoms were offered airflow assessments by electronic mini-spirometry. For any value of FEV 1/FEV6 less than 70%, screening for COPD was considered as positive. Results: Of the 778 patients seen during routine consultations, 273 (35.1%) fulfilled the inclusion criteria. The test was positive in 128 of the eligible patients (46.9 %). The prevalence of proven COPD (ratio<70%) was 13.9% (38 patients). The high-risk factors were age over 60years (P= 0.03), body mass index over 28 (P= 0.04), smoking history of more than 30pack-years (P < 0.0001), presence of clinical signs (P < 0.0001) and industrial exposure to toxic substances (P = 0.03). Conclusions: Targeted screening of patients with risk factors for COPD can be performed in a GP setting. An electronic mini-spirometer is a reliable and inexpensive screening tool. © 2013 SPLF. Published by Elsevier Masson SAS. All rights reserved. Source

Neuville S.,Ecole Centrale Lille | Lannoy D.,Ecole Centrale Lille | Lannoy D.,Laboratoire Of Biopharmacie | Delatre C.,Center Hospitalier Of Roubaix | Bouchoud L.,Pharmacie Des Hopitaux Universitaires Of Geneva
Nutrition Clinique et Metabolisme

The administration of oral medications in patients receiving enteral nutrition is a common problem. The prescription must be reviewed by the doctor to avoid any unnecessary administration and adapt it to the tube administration. The oral route whenever possible is recommended. The choice of the tube should include the possibility of drug administration. Precautions must be observed to avoid tube obstruction, some operations are recommended to unclog the tube. When administered by tube, the liquid forms should be preferred, taking into account certain characteristics (viscosity, osmolarity), which may cause a risk of obstruction or gastrointestinal intolerance. The oral sustained-release or enteric-coated forms should not be crushed. The administration of crushed tablets or capsule contents should be in accordance with precautions to avoid instabilities, interactions or tube obstructions. Drugs containing a toxic substance must be subject to special precautions. © 2013. Source

Dekyndt B.,Institute Of Pharmacie | Bourdon F.,Institute Of Pharmacie | Cuaz-Perolin C.,Institute Of Pharmacie | Walbecq I.,Institute Of Pharmacie | And 6 more authors.
Nutrition Clinique et Metabolisme

Objectives: Viscosity is a criterion in the selection of enteral nutrition (EN) mixtures complementing the main criterion: nutrient composition. The aim here is to assess viscosity in mixtures available on the French market. Methods: Fifty-seven mixtures from 4 suppliers, divided into 24 product types with similar nutritional characteristics were tested. Two parameters were taken into account: (1) viscosity and (2) an estimation of its dispersion on 14 product types for which several mixtures are proposed by different suppliers. For each mixture, tests included direct and indirect measurement of viscosity by estimating gravity flow rate. Results: EN mixtures with similar nutritional characteristics sometimes display considerable variations in viscosity (scale extent of 98 Cp) that may affect administration. Mixtures of the same category containing no fibre have lower viscosity (20%) and a higher flow level (37%) than blends containing fibre. Finally, a relationship between gravity flow rate and viscosity measurements was determined according to Poiseuille's law (. r=. 0.969; P<. 0.0001). Conclusion: Our results show that EN mixtures of comparable nutritional composition can have different viscosities affecting administration conditions. The relationship between gravity flow rate and viscosity according to Poiseuille's law offers the possibility of simply measuring flow rate to assess viscosity. © 2014 Elsevier Masson SAS. Source

Foinard A.,Laboratoire Of Biopharmacie | Decaudin B.,Laboratoire Of Biopharmacie | Decaudin B.,Lille University Hospital Center | Barthelemy C.,University of Poitiers | And 3 more authors.
Anesthesia and Analgesia

BACKGROUND:: Drug incompatibility is a problem, especially when managing patients in intensive care units. We designed the present study to assess the impact of multilumen infusion access devices on the occurrence of known physical drug incompatibility through a controlled in vitro study. METHODS:: Three infusion devices connected to a single-lumen catheter were studied: a standard set with 2-port manifold and 1-m extension set and 2 multilumen infusion access devices: a 3-lumen extension set and a 9-lumen extension set (Edelvaiss-Multiline™; Doran International, Toussieu, France). For the 9-lumen extension set, 3 infusion access combinations were studied. Furosemide, midazolam, and saline were infused simultaneously through 3 infusion devices. Three concentrations of furosemide were tested. The infusion rate of saline (carrier) was initially set at 100 mL/h and stepwise decreased by 10 mL/h until precipitate formation. Physical incompatibility was assessed by 2 tests: visual inspection and the subvisible particle count test according to the European Pharmacopeia. The lowest saline infusion rate to prevent visible precipitate and attain an acceptable particle count (i.e., to pass "the 2 tests") was reported for each infusion set. RESULTS:: The standard set revealed visible precipitate even at the highest saline flow rate (100 mL/h). The 3-lumen device prevented drug precipitation using the 2 lowest furosemide concentrations with a saline infusion rate that decreased with furosemide concentration. The 9-lumen infusion access device prevented drug precipitation whatever the furosemide concentration for 2 access combinations using saline infusion rates of between 20 and 60 mL/h but not for a third access combination, despite saline infusion rates equal to 100 mL/h. CONCLUSIONS:: Infusion device characteristics appear to have an impact on the physical compatibility of the 2 drugs. Under specified conditions, the 9-lumen infusion access device prevents physical furosemide-midazolam incompatibility. Copyright © 2012 International Anesthesia Research Society. Source

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